\u27They say\u27: medical students\u27 perceptions of General Practice, experiences informing these perceptions, and their impact on career intention-a qualitative study among medical students in England

\ua9 Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: The number of UK graduates choosing General Practice training remains significantly lower than the current numbers required to meet the demands of the service. This work aims to explore medical students\u27 perceptions of General Practice, experiences which lead to the development of these perceptions, and the ultimate impact of these on career intention. DESIGN: This mixed-methods, qualitative study used focus groups, semistructured interviews, longitudinal audio diary data and debrief interviews to explore and capture the experiences and perceptions of students in their first and penultimate years of university. SETTING: Three English medical schools. PARTICIPANTS: Twenty students were recruited to focus groups from first and fourth/fifth year of study. All students in these years of study were invited to attend. Six students were recruited into the longitudinal diary study to further explore their experiences. RESULTS: This work identified that external factors, internal driving force and the \u27they say\u27 phenomenon were all influential on the development of perceptions and ultimately career intention. External factors may be split into human or non-human influences, for example, aspirational/inspirational seniors, family, peers (human), placements and \u27the push\u27 of GP promotion (non-human). Driving force refers to internal factors, to which the student compares their experiences in an ongoing process of reflection, to understand if they feel General Practice is a career they wish to pursue. The \u27they say\u27 phenomenon refers to a passive and pervasive perception, without a known source, whereby usually negative perceptions circulate around the undergraduate community. CONCLUSION: Future strategies to recruit graduates to General Practice need to consider factors at an undergraduate level. Positive placement experiences should be maximised, while avoiding overtly \u27pushing\u27 GP onto students

Crossing the Suspension Bridge: Navigating the Road from School Suspension to College Success – How Some Students Have Overcome the Negative Implications of School Suspension to Bridge the Road to College

Out-of-school suspensions for middle and high school students can have negative, long-lasting consequences. Researchers have documented that suspensions have a negative impact on academic development, increase likelihood of dropping out of school, and are associated with a stronger likelihood that students will be involved in the legal system. However, there are students who overcome these negative statistics and matriculate to post-secondary education successfully. This study examines the lived experiences and personal attributes in students’ lives that enabled them to overcome a history of suspension to enter and succeed in higher education. Using Bronfenbrenner’s ecological model, the study’s researchers interviewed individuals who have a history of middle and/or high school suspensions and matriculated to higher education. Findings suggest that sense of belonging; family, home,/school support; and strength of relationships helped participants neutralize the impact and mitigate the negative aspects of suspension

Is rejection a diffuse or localized process in small-bowel transplantation?

Utilization of endoscopy to both visualize and selectively biopsy an intestinal allograft has become the standard for early recognition and treatment of intestinal allograft rejection. Despite the widespread acceptance of the need for selective mucosal biopsies, it has not been shown that the histological features of intestinal allograft rejection are either localized or occur as part of a more diffuse phenomenon within a tubular allograft. To resolve these issues, 88 ileoscopies were performed in 12 small-bowel allograft recipients and mucosal biopsy samples were obtained at 5, 10, and 15 cm, respectively, from the ileal stoma. Each mucosal biopsy was labeled, processed, and evaluated individually for the presence and severity of any evidence for allograft rejection. The data obtained suggest that intestinal allograft rejection is a diffuse process, and biopsies obtained randomly from an ileal graft are likely to demonstrate evidence of allograft rejection when such is present. © 1994 Springer-Verlag New York Inc

Comparative Analyses of Pandemic H1N1 and Seasonal H1N1, H3N2, and Influenza B Infections Depict Distinct Clinical Pictures in Ferrets

Influenza A and B infections are a worldwide health concern to both humans and animals. High genetic evolution rates of the influenza virus allow the constant emergence of new strains and cause illness variation. Since human influenza infections are often complicated by secondary factors such as age and underlying medical conditions, strain or subtype specific clinical features are difficult to assess. Here we infected ferrets with 13 currently circulating influenza strains (including strains of pandemic 2009 H1N1 [H1N1pdm] and seasonal A/H1N1, A/H3N2, and B viruses). The clinical parameters were measured daily for 14 days in stable environmental conditions to compare clinical characteristics. We found that H1N1pdm strains had a more severe physiological impact than all season strains where pandemic A/California/07/2009 was the most clinically pathogenic pandemic strain. The most serious illness among seasonal A/H1N1 and A/H3N2 groups was caused by A/Solomon Islands/03/2006 and A/Perth/16/2009, respectively. Among the 13 studied strains, B/Hubei-Wujiagang/158/2009 presented the mildest clinical symptoms. We have also discovered that disease severity (by clinical illness and histopathology) correlated with influenza specific antibody response but not viral replication in the upper respiratory tract. H1N1pdm induced the highest and most rapid antibody response followed by seasonal A/H3N2, seasonal A/H1N1 and seasonal influenza B (with B/Hubei-Wujiagang/158/2009 inducing the weakest response). Our study is the first to compare the clinical features of multiple circulating influenza strains in ferrets. These findings will help to characterize the clinical pictures of specific influenza strains as well as give insights into the development and administration of appropriate influenza therapeutics

Wave modelling - the state of the art

This paper is the product of the wave modelling community and it tries to make a picture of the present situation in this branch of science, exploring the previous and the most recent results and looking ahead towards the solution of the problems we presently face. Both theory and applications are considered. The many faces of the subject imply separate discussions. This is reflected into the single sections, seven of them, each dealing with a specific topic, the whole providing a broad and solid overview of the present state of the art. After an introduction framing the problem and the approach we followed, we deal in sequence with the following subjects: (Section) 2, generation by wind; 3, nonlinear interactions in deep water; 4, white-capping dissipation; 5, nonlinear interactions in shallow water; 6, dissipation at the sea bottom; 7, wave propagation; 8, numerics. The two final sections, 9 and 10, summarize the present situation from a general point of view and try to look at the future developments

Immunomagnetic t-lymphocyte depletion (ITLD) of rat bone marrow using OX-19 monoclonal antibody

Graft versus host disease (GVHD) may be abrogated and host survival prolonged by in vitro depletion of T lymphocytes from bone marrow (BM) prior to allotransplantation. Using a mouse anti-rat pan T-lymphocyte monoclonal antibody (0×19) bound to monosized, magnetic, polymer beads, T lymphocytes were removed in vitro from normal bone marrow. The removal of the T lymphocytes was confirmed by flow cytometry. Injection of the T-lymphocyte-depleted bone marrow into fully allogeneic rats prevents the induction of GVHD and prolongs host survival. A highly efficient technique of T-lymphocyte depletion using rat bone marrow is described. It involves the binding of OX-19, a MoAb directed against all rat thy-mocytes and mature peripheral T lymphocytes, to monosized, magnetic polymer spheres. Magnetic separation of T lymphocytes after mixing the allogeneic bone marrow with the bead/OX-19 complex provides for a simple, rapid depletion of T lymphocytes from the bone marrow. In vitro studies using flow cytometry and the prevention of GVHD in a fully allogeneic rat bone marrow model have been used to demonstrate the effectiveness of the depletion procedure. © 1989 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted

Multivisceral intestinal transplantation: Surgical pathology

We report the diagnostic surgical pathology of two children who underwent multivisceral abdominal transplantation and survived for 1 month and 6 months. There is little relevant literature, and diagnostic criteria for the various clinical possibilities are not established; this is made more complicated by the simultaneous occurrence of more than one process. We based our interpretations on conventional histology, augmented with immunohistology, including HLA staining that distinguished graft from host cells in situ. In some instances functional analysis of T cells propagated from the same biopsies was available and was used to corroborate morphological interpretations. A wide spectrum of changes was encountered. Graft-versus-host disease, a prime concern before surgery, was not seen. Rejection was severe in 1 patient, not present in the other, and both had evidence of lymphoproliferative disease, which was related to Epstein-Barr virus. Bacterial translocation through the gut wall was also a feature in both children. This paper documents and illustrates the various diagnostic possibilities.. © 1989 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted

Propagation of chaos for rank-based interacting diffusions and long time behaviour of a scalar quasilinear parabolic equation

We study a quasilinear parabolic Cauchy problem with a cumulative distribution function on the real line as an initial condition. We call 'probabilistic solution' a weak solution which remains a cumulative distribution function at all times. We prove the uniqueness of such a solution and we deduce the existence from a propagation of chaos result on a system of scalar diffusion processes, the interactions of which only depend on their ranking. We then investigate the long time behaviour of the solution. Using a probabilistic argument and under weak assumptions, we show that the flow of the Wasserstein distance between two solutions is contractive. Under more stringent conditions ensuring the regularity of the probabilistic solutions, we finally derive an explicit formula for the time derivative of the flow and we deduce the convergence of solutions to equilibrium.Comment: Stochastic partial differential equations: analysis and computations (2013) http://dx.doi.org/10.1007/s40072-013-0014-

Gauge-Independent W-Boson Partial Decay Widths

We calculate the partial decay widths of the W boson at one loop in the standard model using the on-shell renormalization scheme endowed with a gauge-independent definition of the Cabibbo-Kobayashi-Maskawa (CKM) mixing matrix. We work in $R_\xi$ gauge and explicitly verify that the final expressions are independent of the gauge parameters. Furthermore, we establish the relationship between the on-shell and $\bar{\mathrm{MS}}$ definitions of the CKM matrix, both in its generic form and in the Wolfenstein parameterization. As a by-product of our analysis, we recover the beta function of the CKM matrix.Comment: 15 pages; reference added; input parameters updated according to 2000 PDG report; accepted for publication in Phys. Rev.

Thermal phenomenology of hadrons from 200 AGeV S+S collisions

We develop a complete and consistent description for the hadron spectra from heavy ion collisions in terms of a few collective variables, in particular temperature, longitudinal and transverse flow. To achieve a meaningful comparison with presently available data, we also include the resonance decays into our picture. To disentangle the influences of transverse flow and resonance decays in the $m_T$-spectra, we analyse in detail the shape of the $m_T$-spectra.Comment: 31 pages, 13 figs in seperate uuencoded file, for LaTeX, epsf.sty and dvips, TPR-93-16 and BNL-(no number yet